Business
Canada’s health-care system is not ‘free’—and we’re not getting good value for our money
From the Fraser Institute
By Nadeem Esmail and Mackenzie Moir
In 2025, many Canadians still talk about our “free” health-care system. But in reality, through taxes, we pay a lot for health care. In fact, according to the latest data, a typical Canadian family will pay $19,060 (or about 24 per cent of their total tax bill) for health care this year.
Given the size of that bill, it’s worth asking—do Canadians get good value for all those tax dollars? Not even close.
First, Canadians endure some of the longest wait times for medical care—including primary care, specialist consultations and non-emergency surgery—among developed countries with universal health care. In fact, the wait in Canada for non-emergency care is now more than seven months from referral to treatment, which is more than three times longer than in 1993 when wait times were first measured nationally.
Why the delays?
Part of the reason is the limited number of medical resources available to Canadians. Compared to our universal health-care peers, Canada had some of the fewest physicians, hospital beds and medical technologies such as MRI machines and CT scanners.
And before you wonder if $19,000 per year isn’t enough money for world-class universal coverage, remember that Canada has one of the most expensive universal health-care systems in the developed world, which means Canadians are among the highest spenders on universal health care yet have some of the worst access to health-care services.
Fortunately, countries such as Switzerland and Australia, which both provide far more timely access to high-quality universal care for similar or even lower cost than Canada, offer lessons for reform. Compared to Canada, both countries allow a larger degree of private-sector involvement and, perhaps more importantly, competition in their universal health-care systems.
In Switzerland, for instance, health insurance coverage is mandatory and provided by independent insurers that compete in a regulated market. Swiss citizens freely choose between insurers (which must accept all applicants) and can even personalize some aspects of their universal insurance policy. Patients also have a choice of hospitals, more than half of which are operated privately and for-profit.
In Australia, citizens can purchase private insurance, which covers the cost of treatment in private hospitals. Higher income Australians are actively encouraged to purchase private health insurance and even have to pay additional taxes if they do not. Some 39 per cent of hospitals in Australia are private and for-profit, providing care to both privately and publicly insured patients.
Vitally, competition between private health-care businesses and entrepreneurs in both countries (and many others including Germany and the Netherlands) has helped create a more cost-effective and accessible universal health-care system. Back here in Canada, the lack of private-sector efficiency, innovation and patient-focus has led to the opposite—namely, long waits and poor access.
Health care in Canada is not free. It comes with a substantial price tag through our tax system. And the size of that bill leaves less money for savings and other things families need.
Getting better value for our health-care tax dollars, and solving the longstanding access problems patients face, requires policy reform with a more contemporary understanding of how to structure a truly world-class universal health-care system. Until that reform happens, Canadians will continue to be stuck with a big bill for lousy access to health care.
From the Frontier Centre for Public Policy
It’s about politics and provinces are right to refuse to play along
Federal Public Safety Minister Gary Anandasangaree’s leaked admission that Ottawa’s firearms buyback is unenforceable was no slip. It exposed the way federal power is deployed for partisan gain while provinces are left to pay the bill.
The leak matters because it exposes a pattern, not an exception. Ottawa drafts policies to suit its politics and expects provinces to carry the weight. Police budgets, university research chairs, hospital systems and housing markets are treated as levers to be pulled from Ottawa. The effects are felt locally, but the decisions are made elsewhere.
Consider the pattern. The Online Harms Act, rejected more than once, is introduced yet again, as if repetition can substitute for consent. Health care dollars are tied to federal strings that reorder provincial systems with no regard for local capacity. Immigration quotas climb at a pace provinces cannot house or school. Environmental rules descend without negotiation, upending years of co-operative planning. Each measure arrives as an edict. Consultation is reduced to announcement.
Resistance has already begun. Saskatchewan moved early, adopting legislation that makes any federal confiscation program subject to provincial authority, including RCMP operations. In Alberta, Premier Danielle Smith has gone further, declaring flatly: “We will not allow police in Alberta to confiscate previously legal firearms. I have directed two of my ministers to relentlessly defend Albertans’ right to lawful and safe possession of firearms and the right to self-defence.”
Even before the introduction of the Sovereignty Act, Tyler Shandro, then Alberta’s justice minister, announced that the province would not use its police or prosecutors to carry out confiscations. Although former premier Jason Kenney opposed a Sovereignty Act, his government likewise refused to act as Ottawa’s enforcer.
Alberta and Saskatchewan have since given themselves legislative tools, Sovereignty Acts, which assert the right of provinces to decline enforcement of federal laws they judge unconstitutional. These statutes formalize existing constitutional powers. Provinces without Sovereignty Acts have also drawn lines. Ontario has signalled its refusal to help enforce Ottawa’s firearms program.
These positions are lawful, rooted in the Constitution’s division of powers, which assigns the administration of justice and policing to the provinces.
This clarity ought to attract others. Manitoba, with one of the highest proportions of licensed hunters in the country, has strong reason to resist Ottawa’s targeting of lawful gun owners. Communities are not made safer by seizing deer rifles from responsible hunters, nor are public services improved by diverting scarce provincial resources into a program that federal ministers concede will not work. Manitoba would do well to follow Alberta and Saskatchewan in defending its jurisdiction, whether through a Sovereignty Act or by refusing to play Ottawa’s game.
The point is practical. Prairie provinces cannot spare rural detachments to seize hunters’ rifles because the Liberal caucus fears losing seats in Montreal. They cannot put their power grids at risk to meet Ottawa’s timelines while households absorb higher bills. Universities cannot be turned into federal policy pilot projects. Provinces exist to govern their own communities, not to absorb the fallout of federal experiments.
The genius of federalism lies in the division of authority, which encourages compromise and minimizes tyrannical imposition. Ottawa governs in its sphere, provinces in theirs. Where the two overlap, cooperation must be negotiated, not imposed. Sovereignty Acts sharpen that principle. They remind Ottawa that partnership is earned, not dictated.
What Anandasangaree’s admission exposed was not only the cynicism of one firearms program. It revealed a method of governing: federal power deployed for partisan gain, with provinces reduced to instruments. That cannot endure. Canada was never meant to be a chain of command. It was built as a contract—one that requires respect for provincial authority.
Provinces that refuse to carry out Ottawa’s politically motivated projects are not weakening Canada; they are enforcing its terms.
Marco Navarro-Genie is vice-president of research at the Frontier Centre for Public Policy and co-author, with Barry Cooper, of Canada’s COVID: The Story of a Pandemic Moral Panic (2023).
Quick Hit:
Elon Musk on Wednesday became the first person in history to hit a $500 billion net worth, according to Forbes. The Tesla, SpaceX, and xAI founder’s fortune now sits roughly $150 billion ahead of Oracle co-founder Larry Ellison, with Tesla’s surging stock and SpaceX’s record valuation driving the leap.
Key Details:
- Forbes reported Musk’s net worth crossed the $500 billion mark around 3:30 p.m. ET, fueled by Tesla’s nearly 4% stock gain Wednesday — adding roughly $9.3 billion to his wealth.
- Musk’s fortune has grown from $24.6 billion in March 2020 to $100 billion by late 2020, $200 billion in 2021, $400 billion in 2024, and now $500 billion.
- Tesla shares have nearly doubled since April, when Musk said he would step back from his role leading President Trump’s Department of Government Efficiency (DOGE) to focus on Tesla. The EV maker’s market cap is now within 10% of its all-time high, with Musk’s 12% stake worth about $191 billion.
Elon Musk achieved yet another major milestone Wednesday, becoming the first ever person worth $500 billion. Musk, who became the first person ever worth $400 billion or more in December, is $150 billion ahead of runner-up Larry Ellison—and half-way to becoming the world’s first… pic.twitter.com/h9LJmAvT7F
— Forbes (@Forbes) October 1, 2025
Diving Deeper:
Elon Musk made history Wednesday as the first individual ever to surpass a $500 billion personal net worth, according to a report from Forbes. The Tesla and SpaceX CEO’s fortune crossed the milestone in mid-afternoon trading, following another surge in Tesla’s share price and continuing investor confidence in Musk’s technology empire.
Tesla stock jumped nearly 4% Wednesday, pushing the company’s valuation closer to its all-time high. Forbes estimates Musk’s 12% stake in Tesla alone is worth about $191 billion. The remainder of his wealth comes from SpaceX — currently valued at around $400 billion — and his artificial intelligence firm xAI, worth roughly $60 billion.
Musk’s rise in wealth has been staggering. In March 2020, he was worth $24.6 billion. By late 2020, he had crossed the $100 billion threshold, reaching $200 billion in 2021 and $400 billion last year. His $500 billion milestone now puts him more than $150 billion ahead of the world’s second-richest person, Oracle co-founder Larry Ellison.
In a post on X last month, Musk said his compensation and influence over Tesla were not about money, but control over the company’s direction: “It’s not about ‘compensation,’ but about me having enough influence over Tesla to ensure safety if we build millions of robots,” he wrote. “If I can just get kicked out in the future by activist shareholder advisory firms who don’t even own Tesla shares themselves, I’m not comfortable with that future.”
According to Forbes, Tesla’s board recently proposed a new compensation plan for Musk worth as much as $1 trillion — the largest package ever offered to a corporate executive. The plan would grant Musk up to 12% of Tesla’s stock if the company hits a $8.5 trillion market cap and other performance milestones over a decade.
At his current trajectory, analysts suggest Musk could become the world’s first trillionaire by 2033 — an outcome that seemed unthinkable just five years ago. As Musk continues to balance his leadership at Tesla, SpaceX, and xAI, his financial empire appears to be expanding as rapidly as the industries he dominates.
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